School-age children play a critical role in influenza transmission within communities. Therefore, schools are critical to strategies for influenza control. School absenteeism data is widely used by public health officials as an indicator of influenza activity in communities; however, the true relationship between influenza and school absenteeism is not clear. The goal of this proposal is to determine whether elementary school absenteeism is a marker for influenza activity in the school and whether elementary schools are sentinels for influenza activity in the community. My specific aims are to: 1) determine whether elementary school absenteeism rates during the winter respiratory illness season vary by school characteristics including urban or rural, economic status, and school policies of hand hygiene and exclusion of ill students, 2) determine whether elementary school absenteeism precedes other markers of influenza in the community by relating absenteeism data to: a) viral epidemiology data collected by a large regional health care delivery organization, Intermountain Healthcare (IH), and b) influenza-like illness and influenza-associated hospitalization data collected by the Utah Department of Health, and 3) determine whether school absenteeism reflects influenza virus activity in the school by determining the proportion of symptomatic children attending an elementary school who are shedding influenza virus versus other viruses and relating this data to the school's absenteeism rates. This knowledge will improve the value of school absenteeism data when used either for influenza surveillance or as an outcome measure of the effect of influenza prevention programs. The data obtained from the proposed studies will be vital for preparing evidence-based policies for schools and will be the basis for further interventional research regarding influenza mitigation in schools. In addition to my research aim, my specific career development aims include 1) expand my existing skills in study design, analysis, and interpretation of results, 2) develop epidemiologic skills including biologic sampling of closed populations and infectious disease epidemiology, 3) learn about theories of health care behavior and their application in a research setting, 4) develop mediation skills to enable me to foster collaboration between groups, 5) work with educators to build teaching tools that allow teachers to incorporate public health messages into their curricula, 6) develop research management skills to lead projects in the future, 7) develop leadership skills through leadership training. My overarching career goal is to improve the health of disadvantaged children and their communities by understanding and applying basic science to implement and evaluate effective interventions in a school setting. The research and career development aims of this proposal will prepare me to be an independent investigator able to lead both locally and nationally in pandemic planning to ensure safe schools and healthy communities. [unreadable] [unreadable] [unreadable]